Central Nervous System (CNS) Stimulants

Prior Authorization Call Line: 1-877-309-9493

Prior Authorization Fax Line: 1-800-268-2990

Prior authorization of CNS Stimulants for enrollees 18 years of age or older has been implemented to reinforce appropriate use
and to ensure utilization consistent with approved indications. Requests for prior authorization of CNS Stimulants for enrollees
18 years of age or older can be initiated by either prescribers or their authorized agents. An authorized agent is an employee of the prescribing practitioner and has access to the patient's medical records (i.e. nurse, medical assistant).

Prior authorization requirements:

Prescribers or authorized agents are required to respond to a series of questions that identify the prescriber, the patient and the reason for prescribing a drug in this class for enrollees 18 years of age or older.

If you are prescribing CNS Stimulants for enrollees under the age of 18, please review the Preferred Drug List.